Science of Hope

We explore this topic because it is important to learn that hope is an authentic tool in your arsenal against cancer. It is not pie-in-the-sky viewed through rose-colored glasses. Maurice Lamm in The Power of Hope identifies our fear: “We know in our bones that hope is everything. In the back of our minds, we suspect it is nothing at all.”

If we are going to marshal the scientific facts needed to fight this thing we face, then we must use all the facts. And hope is based in science. Little did we know that there are references to the power of hope dating back to the ancient Greeks and Romans. Even 18th century physicians recognized the physiological effects of hope on the body. The research studies on the subject are endless and far too broad to discuss here. Our intention is to introduce you to the basics of the Science of Hope and provide you with resources to pursue further knowledge on your own.

Belief & Expectation

Science journals from the 1960s began printing obscure studies about the power of the “mind/body connection.” It would not be long before Pulitzer and Nobel Prizes were awarded to many scientists and physicians for their discoveries in these fields. Authors soon penned many best-selling books about this phenomenon. Decades of press about the subject means that most of us have heard of the research cornerstone: the “placebo effect.” Simply put, the placebo effect accounts for the fact that something as simple as a “sugar pill” can work as well as a true prescription medicine because we believe and expect that it will.

Take this further, and we can have great improvement from knee surgery that we believed was successful – even when none was actually performed. And some patients with advanced Parkinson’s showed significant reduction in their normally uncontrollable muscle tremors when they expected a new medicine to work – though none was given. Even asthma attacks can be reversed with the placebo effect. Studies with countless different illnesses, injuries, surgeries and treatments all support this fact: what we believe has a tremendous influence on the outcomes of our illnesses and injuries. Too many to list here, we site some of the more renowned studies for exploring on your own in the Resource pull-down menu for this Science of Hope page.

Medical journals abound with example after example proving that what we expect to happen with our bodies – regardless of genuine medical or surgical intervention – will usually happen. Add to this formula the component of desiring a certain outcome, and the mind’s power over the body is even more enhanced. Our Hope Tree artist, Carol Jeanotilla, experienced this phenomenon firsthand many times during her 17 years as a Registered Nurse. She was even the scrub nurse during surgery in the early 1970s for a gallbladder removal done with the patient anaesthetized by hypnosis only.

Which Should I Be: Hopeful or Optimistic?

Hope differs from positive thinking. Positive thinking is passive. Genuine hope requires action and knowledge. No one explains this concept better than Jerry Groopman, MD, in his ground-breaking book, The Anatomy of Hope:

“Hope differs from optimism. Hope does not arise from being told to ‘think positively,’ or from hearing an overly rosy forecast. Hope, unlike optimism, is rooted in unalloyed reality. Hope is the elevating feeling we experience when we see – in the mind’s eye – a path to a better future. Hope acknowledges the significant obstacles and deep pitfalls along the path. True hope has no room for delusion.

Clear-eyed, hope gives the courage to confront our circumstances and the capacity to surmount them. For all my patients, hope, true hope, has proved as important as any medication I might prescribe or any procedure I might perform.

Hope can arrive only when we recognize that there are real options and that you have genuine choices. Hope can flourish only when you believe that what you do can make a difference, that your actions can bring a future different from the present. To have hope then, is to acquire a belief in your ability to have some control over your circumstances. You are no longer entirely at the mercy of forces outside yourself.”

Optimism is certainly a valuable tool in life. It too has a long history of research. And it can be learned – even in adulthood. Under our Resource section, see Dr. Seligman’s ground-breaking research in the very readable book, Learned Optimism. We provide other links to many sites discussing just such findings. But it is hope – authentic hope – that we are in need of now. Let’s learn how to create it.

Knowledge Fuels Hope

Knowledge is a key component to keeping our beliefs and expectations real and, therefore, “believable.” There was a fascinating study done by the military involving basic training with soldiers given nearly impossible marching orders – many miles beyond the norm, packs loaded to twice their capacity. One group was told exactly what they were up against with its staggering odds against success. They were given milestones to reach and informed of changes, revisions and what was coming their way – good and bad. Another group was not told anything about what lay ahead – how far, to where, how long: nothing. They were told only that they needed to keep going with no end in sight. They found that the soldiers who knew exactly what they were up against performed far better physically and mentally with long-lasting higher morale – even exceeding the initial goals. The uninformed troops soon dissolved into negativity, fear, low morale, injuries and did not come close to reaching their goal.

The more you know and understand about your disease and treatment options, the better equipped you are to overcome them. Truly understanding what you are up against and taking an active role in treatment decisions helps your mind and body tap into its genuine belief and expectation – the foundation for all those good chemical reactions that encourage hope. These chemicals also tell us that it is safe to expend energy on healing. And the more we know the better equipped we are to challenge illogical, incorrect thoughts when they appear as free-floating anxious thinking that can soon mushroom into panic and fear.

But it is not only in medical journals where we gain the knowledge we need to cultivate real hope. We also learn from reading or hearing about other people’s stories and how they survived their challenge. The psychology of survival is another area of intense scientific study and well worth investigating. Just such stories are told here on our Inspiration Page, in our Podcasts and in our monthly newsletter, Illuminate, where we feature stories of everchanging guest authors. Once we begin looking for amazing stories of survival they will appear everywhere. As the Buddhist proverb tells us, “When the student is ready, the teacher will appear.”

Our Body’s Pharmacy Is Always Open

The brain chemistry that facilitates such a miraculous coping mechanism is very primitive. We have all likely heard about our body’s “endorphins” being released in relation to sports performance during grueling tests of endurance. These endorphins and “enkephalins” are similar to opiates in their influence over our brains. At its most basic, the function of this primitive reward and reinforcement system is twofold. Our bodies developed this capability to make things that are good for us feel really good so that we will keep doing them. And then when we are injured and need to keep going as a matter of survival, endorphins kick in to ease pain that would otherwise be immobilizing. Both of these brilliant natural maneuvers help us live longer, healthier lives.

Belief and expectation are important triggers that release these good chemicals throughout our brains and body. And this is the critical scientific leap in recognizing the importance of hope and the effect it can have on our bodies. Belief and expectation – critical components in hope – can block pain, encourage healing and temper the damaging effects of fear by producing these potent brain chemicals. The work of Dr. Benedetti – and others noted on the Resource page – explains in much further detail how our brain and spinal cord are then bathed with these brain chemicals – stopping pain from being felt, controlling involuntary muscle movement, controlling asthma attacks, and more.

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Scientists have now proven that these chemicals work in both directions: not only from the mind to the body but also from the body back to the mind. The many signals of recovery in our body – less pain, more energy, the ability to laugh, feeling hungry, sleeping better, enjoying someone’s company – all send organ and tissue messages of their own back to the brain telling it that we are not in danger, that we are improving. Then hope reciprocates with chemical communications of its own back to the organs and tissue – signaling that it is safe to expend energy on healing. These are the crucial interplays between mind/body and body/mind that enhance our feelings of hope and encourage healing. Everything you can do to feel better in any way sends critical chemical signals to the brain that will increase hope.

Liken it to the old Morse Code messages transmitted across the Atlantic: I say this, you receive it, understand and send back your own response. Then I read your message, understand, respond and send another message in return, etc. To have hope remain healthy and fluid we need to keep this lively conversation going within our bodies. Everything we can do to feel better – no matter how small – is heard by our body’s complex communication system. Worldwide, oncologists now stress the importance of an hour’s daily walk during chemotherapy – no matter how tired you may feel – undoubtedly based on this circular chemical communication from the body to the mind and back.

“Hope does not cast a veil over perception and thought. In this way, it is different from blind optimism. It brings reality into sharp focus.”
– Richard Davidson, Ph.D.

Paralyzed by Fear

We have been talking about all these wonderful brain chemicals that help us to nourish hope, which helps us feel better, which in turn signals that it is in fact reasonable to be hopeful. But there is one thing that overwhelms hope: fear.

Also very primitive in its origin, fear is an important survival element. It originates in a place within our brains called the amygdala: Latin for “almond,” which shares the amygdala’s shape. Fear releases its own barrage of chemicals in the body that are responsible for panic, terror and dread. These chemicals make us recognize that we are in imminent danger and must respond immediately: should we run for our lives or freeze in place – trying to go undetected by the threat? We respond with pounding hearts, shallow breathing, muscles contractions and sweat pouring from our brow in an instant.

This is all very helpful when a grizzly bear appears on the path before us. But it is not so helpful when thoughtful consideration of available options is called for. We must be watchful of the early thinking patterns, conversations, TV programs, reading material or films that head us down this path of unbridled panic. It is natural to feel fear when facing a diagnosis of cancer or hearing that treatments are not yet working as designed. Dr. Groopman, again in The Anatomy of Hope, tells us: “Hope incorporates fear into the process of rational deliberation and tempers it so we can think and choose without panic.” But panic only sends our bodies a flood of chemical telegrams that will shut down our healing process and stop hope in its tracks. Thankfully, we have some natural mechanisms to fight panic.

Our Body’s Natural On/Off Switch

It was the ground-breaking work of Herbert Benson summarized in The Relaxation Response which first introduced the notion that we could control our body’s anxiety and fear responses. Much of this work centers around the Autonomic Nervous System (the brain and spinal cord) with its two components: the Sympathetic Nervous System and Parasympathetic Nervous System. Without getting into a tedious anatomy and physiology lesson, basically, the Sympathetic NS is not under our conscious control and the Parasympathetic NS is under our conscious control.

We need the Sympathetic Nervous System to keep our organs functioning whether we are thinking about them or not. This system also controls our “Flight or Fight” mechanism.

There have since been scores of popular books written based on Herbert Benson’s initial research – most of which are available online. We address it here because the techniques used to switch us from Sympathetic (panic mode) to Parasympathetic (in control mode) are useful skills to have on this cancer journey. Remember our earlier reference to the grizzly bear crossing our path? That situation requires the intervention of this immediate and involuntary response. But when we feel ourselves in a panic over imagined dangers and outcomes, we need to call the Parasympathetic Nervous System to the rescue.

This is where the Relaxation Response technique, meditation, yoga, simple five minute sessions of controlled deep breathing and many other calming modalities can help us so much. There are many options to learn this technique. On our Resources page we offer a link to Dr. Benson’s site with a full explanation of his technique. Seek out ways to learn the tactics that appeal to you and use them daily to keep fear and panic under control.

An easy way to keep the two systems straight is the vision of a parasol. Just think of a storm pounding you relentlessly – the Sympathetic NS – and how much comfort and relief you would get from a parasol – the Parasympathetic NS.

The Truth: Your Right & Your Gift

For many decades the norm in medicine was to “spare” the patient and family the whole truth about their illnesses and prognoses. Odds-making on how long we had to live or die were also the norm. Thank goodness those days are over.

While it is natural to want to spare the patient the worry and upset that the honest facts will invoke – in truth, it does not save the patient from anything. In most cases, it increases their suffering and diminishes their capacity to summon all their body’s reserves in the fight for survival. We all have a right to the truth and the emotions that comes with it. Indeed, emotion is a critical component in logical decision making. It was the work of Antonio Damasio, MD, Professor of Neurology at the University of Iowa, who proved that emotions further the process of logic instead of retarding it. It is this worry – based on knowledge and not unbridled fear – that will motivate us to really look at the possibilities and options. Just like the young recruits we started out with, the straight facts – with the challenges and odds clearly laid out – allow us true hope.

Again, Dr. Groopman aptly describes the pitfalls of false hope: “The evasions, the elliptical answers, the parsed phrases were all supposed to be in the service of sustaining hope. But that hope was hollow. It was false, a seductive but only temporarily satisfying illusion. True hope takes into account the real threats that exist and seeks to navigate the best way around them. Those who understand their condition and then choose treatment are not mad nor in denial. To hope under the most extreme circumstances is an act of defiance that permits a person to live life on their own terms.”

Richard Davidson, PhD continues, “Hope does not cast a veil over perception and thought. In this way, it is different from blind optimism. It brings reality into sharp focus.”

Hope Is Renewable.

It’s not as if we feel hope one day and then get to keep it forever. It would be wonderful if hope worked that way: stretch ourselves to cultivate it, let it take root and then just effortlessly allow it to grow all by itself – harvesting our crop whenever extra hope was needed. But hope needs constant renewal like any living thing. It needs fuel, nourishment, protection and tending. Thankfully, we have ways to make more when the current supply diminishes. We have learned how even small things can produce those healthy chemicals that signal our brains and bodies that we are doing well. There are endless resources available for additional scientific information if we still need more proof that “this hope thing” is real.

We must protect our hope reserves fiercely. Keep all that we have learned here and elsewhere in mind every day with proven reinforcement aids: keep a hope and gratitude journal; surround ourselves with positive people; avoid people, conversations, TV shows, news and recordings that diminish our ability to stay hopeful. Learn all we can about our illness and the array of treatment options.

Our hopes are very personal. And no one gets to tell us what to hope for. We are allowed big hopes, medium hopes, small hopes and very teeny, tiny hopes. Our job is to be hopeful about something everyday and keep those good chemicals flowing through our bodies like Morse Code messages across the Atlantic so that we can return to wellness.

Do the homework, get inspired and thrive for as long as possible!

“Without hope, nothing could begin; hope offered a real chance to reach a better end. Hope helps overcome hurdles that we otherwise could not scale, and it moves us forward to a place where healing can occur.”
– Jerry Groopman, MD from The Anatomy of Hope

Food For Thought

One of the greatest discoveries a man makes, one of his great surprises, is to find he can do what he was afraid he couldn't do.

- by Henry Ford

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Please Note

This web site is not a medical or psychological consultation service. Any information or opinion expressed is provided only to supplement information provided by your doctors and nurses. It is not intended as a substitute for competent medical or psychological care. Any use of the information in this web site is at the user's discretion. Carol Jeanotilla and Big3D Productions, Inc. disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this web site, blog or newsletter.